I. Pre-operative preparation

q Secure written consent
q Take standard pre-op photograph
q Give prophylactic antibiotic at least 1 hour prior to surgery
q Wash face with soap and water
q Position patient on the operating table (semi-recumbent position
q Clean operative site with alcohol swab
q Placement of operative marking

II. Operative Techniques

q Sepsis and Antisepsis
q Application of sterile drapes
q Pre-chilling of the skin with ice pocket
q Infiltration of local anesthesia (2% Xylocaine with 1:100,000 epinephrine)
q The rest of the face can be efficiently anesthetized using tumescent anesthesia (0.1% Lidocaine and 1:500,000 epinephrine) obtain a firm surface upon which to operate
q The assistant and surgeon employ three-point traction maneuver to secure the skin
q Abrasion of the deeper scars first and then feather the rest of the face with a more shallow abrasion (18,000 rpm and a standard diamond fraise)
q Homeostasis by gradual pressure using peroxide soaked dressings
q Application of sterile dressing with topical antibiotic.

III. Pre-operative Care

q Take home medication
i.continue prescribed oral antibiotic for 7 days
ii.analgesics for PRN basis
q Advised on proper daily wound care
Follow-up /check-up after 3 days